Holman J K, Hans M G, Nelson S, Powers M P
Dept. of Orthodontics, Case Western Reserve University, Cleveland, OH 44106-4905, USA.
Angle Orthod. 1998 Dec;68(6):527-34. doi: 10.1043/0003-3219(1998)068<0527:AAOEVN>2.3.CO;2.
The extraction of teeth for orthodontic purposes has always been a controversial subject in the specialty. The purpose of this study was to assess the outcome of orthodontic treatment in 100 patients treated with the extraction of four premolars and compare it with the outcome of 100 patients treated without extractions, using the peer assessment rating (PAR) index. Records were selected from 1,198 consecutively completed cases treated by a single provider (MGH) between 1981 and 1995. We chose the first 100 finished patients in each group (extraction and nonextraction) who were under the age of 16 and had no deciduous teeth at the start of treatment. The results of this study show that average treatment time for the extraction group was 29.7+/-6.1 months compared with 26.0+/-7.2 months for the nonextraction group. The extraction group had significantly higher initial PAR scores (T1-PAR ext = 30.01+/-8.20 vs. T1 PAR nonext = 25.21+/-8.55), with greater initial maxillary anterior crowding (PAR ext value = 6.05+/-3.85 vs. PAR nonext value = 4.21+/-2.90) and greater initial overjet (PAR ext value = 1.82+/-1.01 vs. PAR nonext value 1.28+/-1.04). All pretreatment differences were significant at the p < or = 0.0001 level. Although significantly different at the beginning of treatment, both groups were statistically identical at the end (PAR T2 ext = 6.18 + 3.04% reduction = 79.4% compared with PAR T2 nonext = 5.64 + 3.08% reduction = 77.6%). In conclusion, the results demonstrate that, given an additional 3 months of treatment, it is possible for an orthodontist to produce dento-occlusal relationships in extraction patients that are as good as those achieved in nonextraction cases.
出于正畸目的而拔牙在该专业领域一直是个有争议的话题。本研究的目的是使用同行评估评分（PAR）指数，评估100例拔除四颗前磨牙的患者的正畸治疗效果，并将其与100例未拔牙患者的治疗效果进行比较。记录选自1981年至1995年间由单一医生（MGH）连续完成治疗的1198例病例。我们选择了每组（拔牙组和非拔牙组）中最初的100例完成治疗的患者，这些患者年龄在16岁以下，治疗开始时没有乳牙。本研究结果显示，拔牙组的平均治疗时间为29.7±6.1个月，而非拔牙组为26.0±7.2个月。拔牙组的初始PAR评分显著更高（T1 - PAR拔牙组 = 30.01±8.20，而T1 - PAR非拔牙组 = 25.21±8.55），初始上颌前牙拥挤程度更大（PAR拔牙组值 = 6.05±3.85，而PAR非拔牙组值 = 4.21±2.90），初始覆盖也更大（PAR拔牙组值 = 1.82±1.01，而PAR非拔牙组值 = 1.28±1.04）。所有治疗前差异在p≤0.0001水平均具有显著性。尽管治疗开始时两组有显著差异，但在治疗结束时两组在统计学上是相同的（PAR T2拔牙组 = 6.18，减少3.04% = 79.4%，而PAR T2非拔牙组 = 5.64，减少3.08% = 77.6%）。总之，结果表明，在多3个月治疗时间的情况下，正畸医生有可能在拔牙患者中产生与非拔牙病例一样良好的牙合关系。
